Individual provider Active NPI

Tara Roy-Pablo, LMSW

  • Social Worker
  • Casa Grande, AZ
National Provider Identifier
1699590190
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LMSW-12243 Issued in AZ
Practice address
1515 E Florence Blvd Ste 101
Casa Grande, AZ 85122-5334
Phone
(602) 935-6299
NPI assigned
Nov 19, 2024
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-12243 AZ Primary

Addresses

Primary practice location

1515 E Florence Blvd Ste 101
Casa Grande, AZ 85122-5334

Mailing address

4568 E Thistle Landing Dr
Phoenix, AZ 85044-6849
Phone (480) 205-0158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-12243AZMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serendipitous Path, PLLC Social Worker CurrentSince Feb 9, 2025 Accepting new patients

Locations

1515 E Florence Blvd
Ste 101
Casa Grande, AZ 85122
Phone (480) 447-5558

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1699590190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4568 E THISTLE LANDING DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446849",
            "telephone_number": "480-205-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E FLORENCE BLVD STE 101",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225334",
            "telephone_number": "602-935-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY-PABLO",
        "first_name": "TARA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LMSW-12243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.